Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease

A Pilot Study

Alessandro Arrigo, Laura Rania, Alessandro Calamuneri, Elisa Imelde Postorino, Enricomaria Mormina, Michele Gaeta, Silvia Marino, Giuseppe Di Lorenzo, Angelo Quartarone, Giuseppe Anastasi, Domenico Puzzolo, Pasquale Aragona

Research output: Contribution to journalArticle

Abstract

PURPOSE: To describe corneal innervation and trigeminal alterations in drug-naive patients with Parkinson disease (PD).

METHODS: A case series study was conducted by recruiting 3 early drug-naive patients with PD, 2 men and 1 woman (age: 72, 68, and 66, respectively). Ophthalmologic assessment included Ocular Surface Disease Index questionnaire, visual acuity by the logarithm of the minimum angle of resolution score, pupillary light reflexes, extrinsic ocular movements, corneal sensitivity, and slit-lamp examination. Corneal innervation parameter changes were evaluated in vivo using the Confoscan 4 confocal microscope, and they were compared with a control data set. The Heidelberg Retina Tomograph 3 (HRT3) has been used to assess retinal alterations in our patients, if compared with normal range values provided by the HRT3. Moreover, 3T magnetic resonance imaging (MRI) analysis of water diffusion property changes of trigeminal nerves was performed. All data were analyzed and compared with 2 control data sets made by 14 age-matched controls.

RESULTS: Patients with PD showed profound alterations of corneal innervation and of trigeminal diffusion MRI parameters, compared with controls. Strong differences (PD vs. controls) were found for deep nerve tortuosity (Kallinikos mean 19.94 vs. 2.13) and the number of beadings (mean 34.2 vs. 15.5). HRT3 retinal evaluation revealed less structural changes compared with the normal range. Diffusion MRI showed profound changes of white matter diffusion properties (PD vs. controls), with fractional anisotropy decrement (mean 0.3029 vs. 0.3329) and mean diffusivity increment (mean 0.00127 vs. 0.00106).

CONCLUSIONS: Corneal innervation changes might occur earlier in patients with PD than in retinal ones. Confocal corneal innervation analysis might provide possible early biomarkers for a better PD evaluation and for its earlier diagnosis.

Original languageEnglish
Pages (from-to)448-454
Number of pages7
JournalCornea
Volume37
Issue number4
DOIs
Publication statusPublished - Apr 1 2018

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Parkinson Disease
Retina
Reference Values
Diffusion Magnetic Resonance Imaging
Pupillary Reflex
Trigeminal Nerve
Eye Diseases
Anisotropy
Parkinsonian Disorders
Eye Movements
Pharmaceutical Preparations
Visual Acuity
Early Diagnosis
Biomarkers
Magnetic Resonance Imaging
Light
Water
Datasets

Keywords

  • Aged
  • Case-Control Studies
  • Cornea/innervation
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Microscopy, Confocal
  • Parkinson Disease/pathology
  • Pilot Projects
  • Prospective Studies
  • Pupil/physiology
  • Tomography, Optical Coherence
  • Trigeminal Nerve/pathology

Cite this

Arrigo, A., Rania, L., Calamuneri, A., Postorino, E. I., Mormina, E., Gaeta, M., ... Aragona, P. (2018). Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease: A Pilot Study. Cornea, 37(4), 448-454. https://doi.org/10.1097/ICO.0000000000001517

Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease : A Pilot Study. / Arrigo, Alessandro; Rania, Laura; Calamuneri, Alessandro; Postorino, Elisa Imelde; Mormina, Enricomaria; Gaeta, Michele; Marino, Silvia; Di Lorenzo, Giuseppe; Quartarone, Angelo; Anastasi, Giuseppe; Puzzolo, Domenico; Aragona, Pasquale.

In: Cornea, Vol. 37, No. 4, 01.04.2018, p. 448-454.

Research output: Contribution to journalArticle

Arrigo, A, Rania, L, Calamuneri, A, Postorino, EI, Mormina, E, Gaeta, M, Marino, S, Di Lorenzo, G, Quartarone, A, Anastasi, G, Puzzolo, D & Aragona, P 2018, 'Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease: A Pilot Study', Cornea, vol. 37, no. 4, pp. 448-454. https://doi.org/10.1097/ICO.0000000000001517
Arrigo, Alessandro ; Rania, Laura ; Calamuneri, Alessandro ; Postorino, Elisa Imelde ; Mormina, Enricomaria ; Gaeta, Michele ; Marino, Silvia ; Di Lorenzo, Giuseppe ; Quartarone, Angelo ; Anastasi, Giuseppe ; Puzzolo, Domenico ; Aragona, Pasquale. / Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease : A Pilot Study. In: Cornea. 2018 ; Vol. 37, No. 4. pp. 448-454.
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T1 - Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease

T2 - A Pilot Study

AU - Arrigo, Alessandro

AU - Rania, Laura

AU - Calamuneri, Alessandro

AU - Postorino, Elisa Imelde

AU - Mormina, Enricomaria

AU - Gaeta, Michele

AU - Marino, Silvia

AU - Di Lorenzo, Giuseppe

AU - Quartarone, Angelo

AU - Anastasi, Giuseppe

AU - Puzzolo, Domenico

AU - Aragona, Pasquale

PY - 2018/4/1

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N2 - PURPOSE: To describe corneal innervation and trigeminal alterations in drug-naive patients with Parkinson disease (PD).METHODS: A case series study was conducted by recruiting 3 early drug-naive patients with PD, 2 men and 1 woman (age: 72, 68, and 66, respectively). Ophthalmologic assessment included Ocular Surface Disease Index questionnaire, visual acuity by the logarithm of the minimum angle of resolution score, pupillary light reflexes, extrinsic ocular movements, corneal sensitivity, and slit-lamp examination. Corneal innervation parameter changes were evaluated in vivo using the Confoscan 4 confocal microscope, and they were compared with a control data set. The Heidelberg Retina Tomograph 3 (HRT3) has been used to assess retinal alterations in our patients, if compared with normal range values provided by the HRT3. Moreover, 3T magnetic resonance imaging (MRI) analysis of water diffusion property changes of trigeminal nerves was performed. All data were analyzed and compared with 2 control data sets made by 14 age-matched controls.RESULTS: Patients with PD showed profound alterations of corneal innervation and of trigeminal diffusion MRI parameters, compared with controls. Strong differences (PD vs. controls) were found for deep nerve tortuosity (Kallinikos mean 19.94 vs. 2.13) and the number of beadings (mean 34.2 vs. 15.5). HRT3 retinal evaluation revealed less structural changes compared with the normal range. Diffusion MRI showed profound changes of white matter diffusion properties (PD vs. controls), with fractional anisotropy decrement (mean 0.3029 vs. 0.3329) and mean diffusivity increment (mean 0.00127 vs. 0.00106).CONCLUSIONS: Corneal innervation changes might occur earlier in patients with PD than in retinal ones. Confocal corneal innervation analysis might provide possible early biomarkers for a better PD evaluation and for its earlier diagnosis.

AB - PURPOSE: To describe corneal innervation and trigeminal alterations in drug-naive patients with Parkinson disease (PD).METHODS: A case series study was conducted by recruiting 3 early drug-naive patients with PD, 2 men and 1 woman (age: 72, 68, and 66, respectively). Ophthalmologic assessment included Ocular Surface Disease Index questionnaire, visual acuity by the logarithm of the minimum angle of resolution score, pupillary light reflexes, extrinsic ocular movements, corneal sensitivity, and slit-lamp examination. Corneal innervation parameter changes were evaluated in vivo using the Confoscan 4 confocal microscope, and they were compared with a control data set. The Heidelberg Retina Tomograph 3 (HRT3) has been used to assess retinal alterations in our patients, if compared with normal range values provided by the HRT3. Moreover, 3T magnetic resonance imaging (MRI) analysis of water diffusion property changes of trigeminal nerves was performed. All data were analyzed and compared with 2 control data sets made by 14 age-matched controls.RESULTS: Patients with PD showed profound alterations of corneal innervation and of trigeminal diffusion MRI parameters, compared with controls. Strong differences (PD vs. controls) were found for deep nerve tortuosity (Kallinikos mean 19.94 vs. 2.13) and the number of beadings (mean 34.2 vs. 15.5). HRT3 retinal evaluation revealed less structural changes compared with the normal range. Diffusion MRI showed profound changes of white matter diffusion properties (PD vs. controls), with fractional anisotropy decrement (mean 0.3029 vs. 0.3329) and mean diffusivity increment (mean 0.00127 vs. 0.00106).CONCLUSIONS: Corneal innervation changes might occur earlier in patients with PD than in retinal ones. Confocal corneal innervation analysis might provide possible early biomarkers for a better PD evaluation and for its earlier diagnosis.

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KW - Female

KW - Humans

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KW - Microscopy, Confocal

KW - Parkinson Disease/pathology

KW - Pilot Projects

KW - Prospective Studies

KW - Pupil/physiology

KW - Tomography, Optical Coherence

KW - Trigeminal Nerve/pathology

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DO - 10.1097/ICO.0000000000001517

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